× Medical Specialties

Obstetrics Malpractice Premiums

13 years 8 months ago #57628 by sahmd
Lynnecfmd, I'm so sorry to hear about the terrible financial situation you're in. As AnnaM pointed out in the Physician section, sometimes people don't scroll all the way down to Specialties, so maybe that's why you haven't had many replies (up until the current barrage, that is).

Don't be discouraged by the words of those who seem to be hostile toward doctors in general. I hope there is a way that you can make ends meet, even if it means changing practices so that your malpractice premium is covered by someone else. It sounds like a Catch-22 with your lawsuits: you couldn't afford to take time off from work to fight them, and now because of the settlements you can't afford to pay your higher premiums. Ouch!

I wish I had some advice, but I just have support to offer. I also think that this thread should be turned back toward your dilemma, and maybe other posters will chime in with some constructive ideas. I hope it all works out!

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13 years 8 months ago #57629 by dnw826

Originally posted by susanwa1ker:

Originally posted by AnnaM:
So in other words, the answer is to work harder and make less money.

Did you become a doctor to make tons of money?

Originally posted by AnnaM:
Gee, seems fair to me when you compare what insurance company executives make to what they think OB's should make.

Insurance doesn't "think" what people should be paid. It pays what the market can bear. If no one were signing up for insurance contracts, the companies would go out of business.

Originally posted by AnnaM:
I don't mean to be flip, but has anyone noticed how much easier it has gotten to get into OB-gyn residency in the last few years?

It has always been easy. When there were few or no women in med school, it was for the bottom of the class, the impaired physicans and the alcoholics. There was a breif surge in interest from female students.

It has never been very sought after. Why should something uncompetitive pay so much?

Originally posted by AnnaM:
The people in this country will get what they pay for in deciding how much OB's are worth, and it's sad.

I had two kids. The doctor didn't show up on time for either one. They both still tried to bill the insurance. [/b]

Why is your name different? Did you create a new account?

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13 years 8 months ago #57630 by residentmom
To susan "banned" walker-- I am unsure how you determined that you are the only doctor in america whose parents are blue collar, but I can assure you that is not true.

As a resident who currently makes less than the janitorial staff at my hospital, I can tell you that the pay is not fabulous (I realize I will not be a resident forever, but primary care pay is not great, either). It's a shame, because I love it, but I also have debt-- will I have to work so much that I stop loving it?

I worry about people who are convinced of their own greatness, convinced the world is out to get them, and are loud. This makes for a dangerous combination, and these are the people I try desperately to avoid having in my own patient panel.

As you may have heard, there are only 2 kinds of doctors: those who have been sued, and those who will be sued. I can only hope that when it is me, people will offer their sympathy, rather than their judgement. To Lynne-- I hope that you can find a better way to do what you love. Good luck.

ResidentMom<br /><br />"If you bungle raising your children, I don't think whatever else you do well matters very much." --Jackie O.

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13 years 8 months ago #57631 by alternativeMD

I have a hard time following your thread and I don't follow your points, which are many. It seems that you really believe what you say which is based on your hard-earned experiences. I agree with AnnaM. I would be interested to hear in more detail of how you traveled through medicine, and came to these conclusions.

There is so much material in your replies. It goes beyond the scope of a simple discussion.

If I may, I would just like to point out the single phrase that shocked me like a lightening bolt.

You stated, primary care doctors just stick their heads in the patients' room and bill.

I have never poked my head into the door and billed. The last patient I saw, before I left clinical medicine was a woman with 14 active issues going on in the hospital, with 7 consultants on the case (surgery, GI, Heme, ID, hospitalist, pulmonary, radiology). Her medical issues--all active--at the time were: portal vein thromosis, hypoxia of unknown etiology, cellulitis, fungal infection, hepative cirrhosis/hypertension with ascities that needed to be drained and then was leaking all night, hypokalemia, new onset A-fib, hyperphosphatemia, central vein clotting, diabetes out of control, transaminitis, post-op nausea vomiting, developing heel decubitus. She was on at least 12 different medications. Someone had to keep it all togehter, and that person was me, the generalist, not a frivolous bystander. She was a worker at Staples and had no insurance but her husband was a retired government employee so she had Government FEP (Federal Employment Program) BC/BS, one of the better insurances. You can imagine her astronomical medical bill. Do you expect her to pay this out of pocket? Well, I spent at least 2 hour each day on her case, sorting out the various issues that the specialists were not aware of (for example, calling her OB, to make sure that estrogen should be stopped given her portal vein thrombosis; talking to her hematologist about the pros and cos of TIPS in the setting of recurrent surgery and bleeding complications; alerting her general surgeon the rational of the ID specialists' concern for recurrent hosptial acquired skin infections in delaying surgery, etc). A couple of nights I stayed up to stay in touch with her nurses to make sure that she got her VQ and CT done to rule out an PE, and that she was diuresed. I billed the insurance company for over 14 days of work, a total amoutn of about $1900. The insurance company denied my claims, and refused to give me a telephone number for me to talk to an agent, because I was not a participating provider--even though the law states that I could bill for emergency services as a non participating provider. To date, I have not seen a single dime, and $1900 worth of medical services was left unpaid for.

Yes. Maybe I am weak. I could call the patient to ask her to pay. I could mangle it out with the insurance company. I could start a campaign of telephone calls and paperwork with the patient, the state, and the insurance company. I could put in extra hours of work so I could get paid for the work I did. SAHMD has been helping me to try to recuperate the money. But, you know what, at this point, I have just walked away. Why? Because I am tired. Because it just makes me angry. Because if I was running an autoshop or a hotel, things like this would not happen. Because there are people who believe that doctors are rich folks who have it easy, and who are greedy cheating bastards.

But the most important reason that I no longer want to be in this world is that I found a great job away from clinical medicine, and I left it for good--never happier professionally. I rather not think about the nightmare. It's a strong word. But I do think many of us live in a nightmare of clinicall medicine (not all, but many). The doctors who are being sued, aren't they living in the nightmare of clinical medicine? The doctors who are being told how to practice medicine by cost cutting; aren't they living in a nightmare as they see patients suffer the consequence? I walked away, and I don't look back. The profession has lost a good doctor but I am not the only one. The current dysfunctional system is inserting a selection pressure that weeds out the conscientious and thorough folks, and selects those doctors who think 85% is good enough, and another group of doctors who are greedy. The former group, I don't criticize them because how you practice medicine and balance life is an individual choice, but the latter group is just criminal. When I was in my first practice out of residency, my colleague, a young woman doctor, told me that before she came to work everyday, she would sit on the bus in New York City, and cry on her way to work.

I agree with you 100% in saying that doctors are a weak group. We don't run for offices. We don't sit on the benches as judges. We don't prosecute as district attorneys. We don't make laws as legislators. We don't contribute as much to political contributions as the pharmaceutical companies or the insurance companies do. But we are doctors, not businessmen, bankers, politicians, lawyers, CEOs, etc. We are too afraid to ask for cash payment for our services. We are taught to let other people think for ourselves. Most of us are herd followers--we are good at being told what to do, and we are very good at jumping through fences to accomplish what it is required of us: MCAT, med school admissions, Boards, Residency, Licensure, etc. We then feel entitled to be treated fairly, and get a big check.

As a med student or premed, I never realized importance to be politically active to ensure that our socieyt has a just, fair, quality medical system that doesn't encourage waste, and frivolous treatment. Unfortunately once we are out of residency, we are older, weary, and tired, and then we go to our next step in life--paying off our loans, tending to our families, preparing for our retirement, and all the while trying to retain a little piece of what is left of our humanity. In medical school and residency, we were nobodies. We were told what to do. Then when we get out in practice, we are still being told what to do. No wonder other people think we are weak. We can't unionize because it's against the law.

I implore ourselves to think about this topic. I hope the next generation of young physicians will be taught to stay committed to these important issues outside of medicine. Will medical schools teach this stuff to our medical students--rather than make them instead memorize the stupid Krebs Cycle?

We can stay aware, and stay active. Maybe I should go back and fight with BCBS for the payment on principle alone. We need to loosen up our purse strings to contribute to organizations that are effective and are meaningful. Take whatever little time we have to become engaged--maybe go to a meeting once a month, give a lecture once every 6 months, or meet with a state politician once a year. And in this spirit, I think discussion with someone who has an opposite point of view (like yours) is critical.

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13 years 7 months ago #57632 by MomMD
Susan has been banned and will be unable to reply.


President, MomMD<br />Connecting Women in Medicine - Welcome all physicians, resident physicians, medical students and premedical students!

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13 years 7 months ago #57633 by Kristina
Do the salaries for OB/GYNs at salary.com hold any water for your area?

Kristina<br />Pre-Med for OB/GYN - Fall 2006<br />Mother, Wife, Doula, Childbirth Educator<br /> <a href=" www.dynamicdoula.com " target="_blank"> www.dynamicdoula.com </a>

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